Provider Demographics
NPI:1083839005
Name:GLOD, KATHERINE MAY (RN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAY
Last Name:GLOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 COVE RD
Mailing Address - Street 2:
Mailing Address - City:WALES
Mailing Address - State:MI
Mailing Address - Zip Code:48027-2909
Mailing Address - Country:US
Mailing Address - Phone:810-357-4681
Mailing Address - Fax:
Practice Address - Street 1:1405 COVE RD
Practice Address - Street 2:
Practice Address - City:WALES
Practice Address - State:MI
Practice Address - Zip Code:48027-2909
Practice Address - Country:US
Practice Address - Phone:810-357-4681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704316609163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse